Healthcare professionals’ involvement in breaking bad news to newly diagnosed patients with motor neurodegenerative conditions: a qualitative study

Purpose Research on breaking bad news (BBN) in healthcare has mostly focused on the doctor-patient interaction during a single consultation. However, it has been increasingly recognised that BBN is a wider process that also involves other healthcare professionals. This qualitative study explored non-medical1 healthcare professionals’ involvement in BBN to newly diagnosed patients with motor neurodegenerative conditions in the UK. Materials and methods 19 healthcare professionals working with people with motor neurone disease, multiple sclerosis, Parkinson’s disease or Huntington’s disease took part in individual, semi-structured interviews which were analysed using thematic analysis. Results Four themes were constructed: dealing with the diagnostic aftermath, unpacking the diagnosis, breaking bad news as a balancing act and empowering patients to regain control over their health and lives. Participants reported being broadly involved in BBN by supporting patients with negative diagnostic experiences, re-iterating diagnostic information and helping patients understand the impact of their condition. The challenges of effectively breaking bad news and how these difficult conversations could help empower patients were also emphasised. Conclusions BBN was a critical and challenging aspect of healthcare professionals’ clinical work with newly diagnosed patients with motor neurodegenerative conditions. Besides providing information, BBN was perceived as a way to educate patients, encourage them to make decisions and prepare for the future

Attitudes of venture capital investors towards entrepreneurs with previous business failure, Belfast (June)

Business failure represents a significant outcome of entrepreneurial activity and yet remains an underdeveloped area of research. This article focuses on the attitudes of VC investors towards entrepreneurs with a previous failure experience. It illustrates that VCs recognise the complex, contextual nature of failure and do not necessarily perceive the entrepreneur to be the primary cause of the venture's demise. Consequently, the article differentiates between 'business', 'entrepreneurial' and 'venture capitalist' failure. The article demonstrates that VCs often adopt a tolerant, flexible and open-minded attitude to failure and are keen to understand the circumstances in which it occurred. The majority of the VCs in the study emphasise that their decision to invest in an entrepreneur is not negatively affected to any significant degree by a previous experience of failure. A number of influential factors are presented, such as a high quality concept, which can offset this aspect of the entrepreneur's track record. The article concludes that business failure is not automatically considered a 'black mark' by VCs. It is important for entrepreneurs involved in business failure to be aware of these positive and sympathetic attitudes when considering putting forward new proposals to the VC community

‘It's a double whammy’ A qualitative study of illness uncertainty in individuals with Parkinson's disease in the context of COVID-19

Objectives: The purpose of this study was to explore the experiences of individuals with Parkinson's through the theoretical lens of illness uncertainty during the first UK full lockdown period (March–June 2020) put in place due outbreak of the COVID-19 pandemic. Methods: Individual semi-structured interviews were carried out via telephone in May 2020 with 10 individuals with Parkinson's (six men and four women) recruited from Parkinson's UK. Interviews were recorded and transcribed verbatim, and thematic analysis was adopted to analyse the resulting data. Results: Four overarching themes emerged from the interview data: (1) COVID-19 amplifying existing fears and difficulties around the uncertainty of Parkinson's; (2) practical and psychological efforts to manage uncertainty; (3) benefit-finding as a way of acknowledging the positives of lockdown; (4) risk and future management in the context of uncertainty. Discussion: Participants reported a range of implicit and explicit strategies to cope with the ‘double whammy’ of uncertainty caused by having Parkinson's during a global pandemic. While these were generally successful in maintaining well-being, it is important that such successful accounts are used to help inform novel strategies and interventions targeting individuals who might need additional support

Impact of CONSORT extension for cluster randomised trials on quality of reporting and study methodology : review of random sample of 300 trials, 2000-8

Peer reviewedPublisher PD

Conflito trabalho-família, auto eficácia parental e estilos parentais percebidos em pais e mães da cidade de Talca no Chile

The relationship between levels of work-family conflict, parental self-efficacy and perceived parenting styles in a group of 43 school children and both working parents is analyzed, controlling for socio-demographic variables. Also, gender differences are identified in the variables and the relationship between them in relation to the number of children. Three instruments were applied to the sample for measuring the referred variables. A significant and negative relationship is observed between levels of work-family conflict and parental self-efficacy (r = -0.484, P <0.001). The authoritarian parenting style has greater association with self-efficacy (r = 0.301, P = 0.005). A significant and negative relationship between self-efficacy and number of children (r = -0.257, P = 0.017) is reported. Finally, it is concluded that women have greater work-family conflict than men.Se analiza la relación existente entre los niveles de conflicto trabajo-familia, autoeficacia parental y estilos parentales percibidos en un grupo de 43 niños estudiantes y ambos padres trabajadores, controlando las variables sociodemográficas. Así mismo, se identifican las diferencias por género en las variables, y la relación que existe entre ellas con respecto al número de hijos. A la muestra le fueron aplicados tres instrumentos de medición de las variables referidas. Se observa una relación significativa y negativa entre los niveles de conflicto trabajo-familia y la autoeficacia parental (r= -0,484; p<0,001). El estilo parental autoritario presenta mayor asociación con autoeficacia (r=0,301; p=0,005). Se reporta una relación significativa y negativa entre autoeficacia y número de hijos (r=-0,257; p=0,017). Finalmente se reporta que las mujeres presentan mayor conflicto trabajo-familia que los hombres.Analisa-se a relação existente entre os níveis de conflito trabalho-família, auto eficácia parental e estilos parentais percebidos em um grupo de 43 crianças estudantes de pais trabalhadores, controlando as variáveis sociodemográficas. Assim mesmo, identificam-se as diferenças por gênero nas variáveis, e a relação que existe entre elas com respeito ao número de filhos. Foram aplicados à mostra três instrumentos de medição das variáveis referidas. Observa-se uma relação significativa e negativa entre os níveis de conflito trabalho-família e a auto eficácia parental (r= -0,484; p<0,001). O estilo parental autoritário apresenta maior associação com autoeficácia (r=0,301; p=0,005). Reporta-se uma relação significativa e negativa entre autoeficácia e número de filhos (r=-0,257; p=0,017). Finalmente reporta-se que as mulheres apresentam maior conflito trabalho-família que os homens

Vulnerable and forgotten: The impact of the COVID-19 pandemic on autism special schools in England

The COVID-19 pandemic has caused, and continues to cause, unprecedented disruption in England. The impact of the pandemic on the English education system has been significant, especially for children and young people with special educational needs and disabilities (SEND). While it was encouraging that the educational rights of children and young people with SEND were highlighted during the COVID-19 pandemic, Government decision-making appeared to be centered around the needs of pupils in mainstream schools. In this article, co-authored by an academic researcher and senior leaders from the Pan London Autism Schools Network (PLASN; a collective of special schools in London and the South East of England, catering for pupils on the autistic spectrum), we reflect on the impact of the COVID-19 pandemic on special schools in England. We document and discuss a range of challenges experienced by PLASN schools, including the educational inequalities that were exposed and perpetuated by the COVID-19 pandemic, as well as the manner in which the needs and realities of special schools were overlooked by the Government. We also detail the creative and innovative solutions implemented by PLASN schools to overcome barriers that they encountered. These solutions centered on facilitating holistic approaches to support, ensuring clear and regular communication with families, providing effective support for home learning, and promoting collaborative ways of working; all of which align with good practice principles in autism education more generally, and are essential elements of practice to maintain post-pandemic. We additionally reflect on how the COVID-19 pandemic could be a catalyst for much-needed change to the SEND system: leading to better educational provision, and therefore better outcomes, for pupils with SEND

Exploring young people's and youth workers' experiences of spaces for ‘youth development’: creating cultures of participation

The paper focuses on the emergence of ‘positive youth development’ and its impact on older, more established practices of working with young people, such as youth work. Drawing on ethnographic fieldwork in England between 2004 and 2006, in particular young people's and youth workers' accounts of participating in youth work, the analysis engages with the social spaces in which youth work takes place and asks key questions about why young people might participate in youth spaces, what they get out of participating and how such spaces can promote cultures of participation. The analysis shows that such spaces provide young people and their communities with biographical continuity and time becomes a key component for sustaining such spaces. The argument is made for a more nuanced understanding of what young people get out of their participation in youth spaces, and for an epistemological approach to youth praxis that embraces the messiness and inequalities of lived experience

Academic self-concept, gender and single-sex schooling

This paper assesses gender differences in academic self-concept for a cohort of children born in 1958 (the National Child Development Study). We address the question of whether attending single-sex or co-educational schools affected students’ perceptions of their own academic abilities (academic self-concept). Academic selfconcept was found to be highly gendered, even controlling for prior test scores. Boys had higher self-concepts in maths and science, and girls in English. Single-sex schooling reduced the gender gap in self-concept, while selective schooling was linked to lower academic self-concept overall

Latina and European American Girls’ Experiences with Academic Sexism and their Self-Concepts in Mathematics and Science During Adolescence

The study investigated Latina and European American adolescent girls’ (N = 345, M = 15.2 years, range = 13 to 18) experiences with academic sexism in mathematics and science (M/S) and their M/S perceived competence and M/S value (liking and importance). M/S academic sexism was based on girls’ reported experiences hearing sexist comments about girls’ abilities in math and science. Older European American adolescents, and both younger and older Latina adolescents, who experienced several instances of academic sexism felt less competent in M/S than girls who experienced less sexism (controlling for M/S grades). In addition, among older girls (regardless of ethnicity), those who experienced several instances of academic sexism valued M/S less than girls who experienced less sexism